Motor System (Supraspinal Control 2: Large Group Discussion (NB.037)

Question 1

Question 2

Answer 2

Question 3

Answer 3

Question 4

Answer 4

Question 5

3)What happen in case of imbalance between direct and indirect pathways of the basal ganglia?

• It causes hypokinetic disorders in case:

Answer 5

• insufficient direct pathway output

• excess indirect pathway output

Question 6

3)What happen in case of imbalance between direct and indirect pathways of the basal ganglia?

-It causes hyperkinetic disorders in case

Answer 6

• excess direct pathway output

• insufficient indirect pathway output

Question 7

Hypokinetic disorders that may result from damage to the basal ganglia?

Answer 7

Parkinson’s disease; prevent movement initiation.

Question 8

Hyperkinetic disorders that may result from damage to the basal ganglia? And exactly what structure is damaged in each?

Answer 8

-ballism (damage to the subthalamic nucleus)

-Huntington’s disease (degeneration of striatal cholinergic and GABA-ergic neurons)

Question 9

What is ballism?

Answer 9

Hyperkinetic disorder due to damage to the subthalamic nucleus

Question 10

What is Huntington’s disease?

-type of neurons affected

Answer 10

Hyperkinetic disorder due to damage to the degeneration of striatal cholinergic and GABAneurons

Question 11

Answer 11

Question 12

Factors affecting the intensity of Static Tremor in Parkinson’s?

Answer 12

(at rest), affecting one or both hands, the fingers in a pill-rolling motion, may affect tongue, legs, jaw. ↓ by movement & absent during sleep↑ by emotional tension or fatigue.

Question 13

What’s the pathology:

• Difficulty in initiating rapid fine movements. shuffling gait (slow to start , small steps), reduced arm swinging, impaired balance on turning .

Answer 13

Hypokinesia

Question 14

Define Rigidity in terms of:

-effect on posture

-effect on facial expression

-effect on speech

-effect on reflexes

Answer 14

3-Rigidity (↑muscular tone):

-Stiffness and flexed posture

• Mask face (loss of facial expression)
• Slow monotonous speech

-No hyper-reflexia as the tone is high in flexors and extensors

Question 15

Medical treatment for Parkinson’s?

Answer 15

Question 16

Surgical treatment for Parkinson’s?

Answer 16

Question 17

Effect of Thalamotomy on bradykinesia & rigidity?

Answer 17

bradykinesia usually remains, and rigidity improves variably

Question 18

Effect of “Electro coagulation of ventrolateral nucleus of thalamus” on tremor?

Answer 18

tremor resolves on the contra lateral side

Question 19

Why is Pallidotomy considered as one of the surgical treatments for PD?

Answer 19

to remove its basal inhibition on thalamus and cortex

Question 20

Risky complications of Pallidotomy?

And why do they happen?

Answer 20

has risks: including blindness and hemiparesis, due to the proximity of the pallidum to other critical structures (the optic tracts and internal capsule).

Question 21

What is Deep Brain Stimulation?

Answer 21

Question 22

Define Athetosis

Answer 22

Characterized by continuous, slow writhing movements

Question 23

What is the pathophysiology of chorea?

Answer 23

Question 24

3 causes of chorea ?

Answer 24

1- As a complication for rheumatic fever (Sydenham’s chorea), self limited –no dementia.

2- Congenital (Huntington’s chorea): Progressive dementia-fatal (Dementia means decreased memory and cognitive function)

3-May occur in females due to toxemia of pregnancy.

Question 25

What is Sydenham’s chorea?

Answer 25

chorea As a complication for rheumatic fever

Question 26

2 clinical presentations of chorea?

Answer 26

1-Hypotonia and pendular knee jerk 2-Involuntary movements: sudden purposeless dancing movements of arms, legs, face, head and trunk (↑by emotions and ↓ by sleep).

Question 27

What causes hemiballismus?

Answer 27

Question 28

clinical presentation of Hemiballismus? 2 points

Answer 28

1- Hypertonia. 2-Involuntary movements: Attacks of rapid violent movements (half of the body) ➔ may cause loss of balance. may be fatal due to spasm of the respiratory muscles.

Question 29

A fatal complication of Hemiballismus?

Answer 29

2-Involuntary movements: Attacks of rapid violent movements (half of the body) ➔ may cause loss of balance. = “may be fatal due to spasm of the respiratory muscles”

Question 30

Meaning of the word Athetosis?

Answer 30

Question 31

What causes athetosis ? - region and type of neurons affected

Answer 31

Lesion in lentiform nuclei mainly globus pallidus (degeneration of GABA releasing neurons projecting to the thalamus).

Question 32

clinical presentation of Athetosis ? 2points

Answer 32

Question 33

Answer 33

Question 34

Lesion in vestibulocerebellum (archicerebellum) leads to?

Answer 34

Question 35

Answer 35

Question 36

Answer 36

Question 37

Answer 37

Question 38

Lesion in cerebrocerebellum leads to?

Answer 38

Neocerebellar syndrome

Question 39

Causes of Neocerebellar syndrome? Are the associated affections contra or ipsilateral?

Answer 39

Question 40

C/P of Neocerebellar syndrome?

Answer 40

I- Motor ataxia II- Athenia III- Hypotonia

Question 41

Definition of Motor ataxia?

Answer 41

Question 42

Complications of Motor ataxia?

Answer 42

Question 43

What is Asynergia?

Answer 43

Inability to perform two voluntary acts at the same time due to loss of co-ordination between different muscle groups

Question 44

What is Dysmetria?

Answer 44

(Inability to control distance of movement ): movement overshoot the intended point

Question 45

What is Dysdiadochokinesia?

Answer 45

loss of predictive function and slow initiation) : inability to do rapid and alternating opposite movement

Question 46

What is Dysarthria?

Answer 46

scanning or stacatto speech due to decomposition of movements, loss of coordination and prediction of buccal, laryngeal, and respiratory movements

Question 47

What is Nystagmus?

Answer 47

Involuntary, rapid oscillation of the eyeballs in a horizontal, vertical, or rotary direction, with the fast component maximal toward the side of the cerebellar lesion

Question 48

Define Asthenia and it’s cause

Answer 48

Question 49

What is Hypotonia

Answer 49

Question 50

Answer 50

Question 51

Compare between sensory ataxia and motor ataxia in terms of: -proprioceptive sensations. -sign on closing eye. - Compensation by vision -tremors - Nystagmus -Dysarthria -GAIT

Answer 51

Question 52

Function of Inferior Olivary Nucleus? In three points

Answer 52

Question 53

Answer 53

Question 54

Answer 54